Individual
DR. PEGGY SCHUTTE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050
(815) 759-3100
(815) 363-9094
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 759-3100
(815) 363-9094
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02002258A
IN
207P00000X
Emergency Medicine Physician
Primary
036105438
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387519
ANTHEM
IN
01
—
036105438
STATE LICENSE
IL
05
—
200175310
—
IN
01
—
90001082
BCBS
IL
01
—
P00277561
MEDICARE RAILROAD
IN
Enumeration date
04/19/2006
Last updated
07/21/2022
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